The Pap smear was developed and named by doctor Dr. George Papanicolao in 1928, and its purpose was to help along the early identification of cervical cancer. But, for many years all women were led to believe that cervical cancer was a very common occurrence and that ANY woman was at risk; that is simply not so, here is why.
99% of cervical cancer cases were caused by human papillomavirus, a sexually transmitted infection. It is contracted through direct skin to skin contact during sex; vaginal, anal, or even oral sex. It is harbored within the cells of the entire genital region.
Cervical cancer itself is rare, and most times HPV infections are cleared before they lead to cervical cancer. Many women have been encouraged to have the annual Pap test regardless of the risk factors or not. Over the past decade, women’s health experts have recognized that such frequent testing not only does not provide greater protection from cancer, but it may be causing serious medical harm.
“We understand the natural history of cervical cancer much better than any other cancer,” said Dr. Mark Einstein, director of clinical research for women’s health and gynecologic oncology at the Albert Einstein Cancer Center in the Bronx, New York. “And what we’ve learned is the way we used to do pap testing while it was highly effective, we were also causing a lot of potential harm to patients.”
Informed consent on cervical cancer screening is completely lacking in this country. Women are told they need the tests but are rarely told otherwise or even asked if they want them.
A recent World Health Organization guide on cervical cancer control recommends:
- New programmes should start screening women aged 30 years, or more
- existing programmes should not include women less than 25 years of age
- A five-year screening interval is appropriate for women over 50 years
- A three-year interval is considered appropriate in the age group 25-49 years
- Annual screening is not recommended at any age
- Screening is not necessary for women over 65 years provided the last two previous smears were negative.
European guidelines recommend screening for cervical abnormalities “starting at the age of 30 and not before the age of 20”.
Please do not read this, and think that All Pap Smear testing is dangerous or unnecessary, but the fact is too much of a good thing can be dangerous.
“This happens because of this general and wrong idea that the more exams we do, the better health we have.”
Overscreening is a direct breach of “Primum non nocere”, an ethic principle taught in medical schools which mean “First, do no harm.”
“False positives — that is, a test indicates the existence of disease when in fact none is present — are very common and often lead to invasive testing that can produce long-term complications, including difficulties with pregnancy and delivery.”
Many Doctors are for the testing every one or two years, and that is completely unnecessary; in some cases even dangerous. Annual Pap testing does nothing more than send the risk of a false positive and potentially harmful excess biopsy or over-treatment through the roof. Stay informed, and remember in any case you have the right to say no and find another doctor. It is your body and your life.
Debbie Saslow, ACS’s director of breast and gynecologic cancer, sums it up this way: “We now know that annual screening causes more harm than good because it leads to many extra invasive procedures without increasing the number of cancers detected.”